Scalene Muscle Stretch

  N O T E : Because the scalene muscles are attached to the transverse processes of the upper cervical spine and the upper two ribs, they either flex the cervical spine or elevate the upper ribs when they contract bilaterally. Unilaterally,the scalenes side-bend the cervical spine to the same side and rotate it to the opposite side.

首先让我们来看看斜角肌的功能与解剖。斜角肌分前中后三束，起于上颈椎的横突，止于第1,2肋（前束和中束止于第1肋）。一侧斜角肌收缩，使颈椎向同侧侧屈，向对侧旋转，双侧收缩，屈曲颈椎或提升第1，2肋骨。  

牵伸方法如图所示：
患者坐位，瞩患者下巴内收，头顶天花板，让颈椎充分伸直，然后向健侧侧屈，向患侧旋转。达到图示的位置。医生站在患者身后，同时固定头部（让患者的头部紧贴自己身体）和胸廓顶（按压点偏后方，因前方有锁骨），瞩患者深吸气，医生同时用手按压胸廓顶施加阻力。斜角肌做等长收缩，屏气6秒钟后透气，由于自生抑制Autogenic Inhibition的神经学原理，斜角肌在收缩后放松，随胸廓的下降得到很好的牵伸。

 

 Manual Stretching
Patient position and procedure: Sitting. The patient first performs axial extension （动作与颈椎后伸extension不同）(tucks the chin and straightens the neck，下巴内收，头顶天花板) and then side-bends the neck opposite and rotates it toward the tight muscles. Stand behind the patient and stabilize the upper ribs with one hand over the top of the rib cage on the side of tightness and stabilize the head with the other hand around the side of the patient’s head and face, holding the head against your trunk .The patient inhales and exhales; stabilize the ribs with a downward pressure as the patient inhales again. Repeat.This is a gentle, hold–relax stretching maneuver.

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图解：Unilateral active stretching of the scalenus muscles.

The patient first performs axial extension, then side-bends the neck opposite and rotates it toward the tight muscles. The therapist stabilizes the head and upper thorax as the patient breathes in, contracting the muscle against the resistance. As the patient relaxes, the rib cage lowers and stretches the muscle.